<p>Associations between <i>STH</i> infection/non-treatment and performance in c... more <p>Associations between <i>STH</i> infection/non-treatment and performance in cognitive and educational domains among school-aged children following exclusion of outlier investigations using the Galbraith plot method.</p
<p>Effect of <i>STH</i> infection/non-treatment on performance in cognitive and... more <p>Effect of <i>STH</i> infection/non-treatment on performance in cognitive and educational within strata of study designs, non-outlier investigations and study quality.</p
Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) con... more Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) concentration and to observe theeffect of single dose albendazole treatment on Hb concentration.Methods An experimental study was carried out from March toJuly 2002 on primary school children at Suka Village, Tiga PanahSubdistrict, Karo Regency, North Sumatera Province. From 366children who suffered from helminthiasis, 113 were selected assubjects by simple random sampling. Subjects were treated with asingle oral dose of 400 mg albendazole. Hb concentration wasexamined using the cyanide method twice i.e., prior to and threemonths after treatment with albendazole.Results It was found that among 113 subjects, the prevalences ofAscaris lumbricoides, Trichuris trichiura, and mixed infestation were18.3%, 40.4%, and 41.3%, respectively, while the prevalence ofanemia was 33.0%. There was no significant difference in age,gender, nutritional status, and mean Hb concentration betweenchildren sufferin...
<p>Log SMD: logarithm of standardized mean difference; SE: Standard error. Studies that lie... more <p>Log SMD: logarithm of standardized mean difference; SE: Standard error. Studies that lie below the– 2 or above the +2 confidence limit are the outliers.</p
<p>Diamond denotes the pooled standardized mean difference (SMD). Squares indicate the SMD ... more <p>Diamond denotes the pooled standardized mean difference (SMD). Squares indicate the SMD in each study, with square sizes directly proportional to the weight contribution (%) of each study. Horizontal lines represent 95% confidence intervals (CI). The Z test for overall effect indicates non-significance given that <i>P</i> > 0.05. The chi-square test indicates that heterogeneity (P = 0.12, I<sup>2</sup> = 33%) was reduced by outlier treatment. SD: standard deviation; CI: confidence interval; Std: standard; df: degree of freedom; I<sup>2</sup>: measure of variability expressed in %.</p
<p>Comparison of pooled effects between <i>STH</i> infection and respective out... more <p>Comparison of pooled effects between <i>STH</i> infection and respective outcomes with and without co-prevalent <i>Schistosoma</i> infection.</p
<p>Risk of bias in observational studies using the Newcastle-Ottawa quality assessment scal... more <p>Risk of bias in observational studies using the Newcastle-Ottawa quality assessment scale.</p
European Journal of Clinical Microbiology & Infectious Diseases, 2012
The purpose of this investigation was to evaluate the association of enteroaggregative Escherichi... more The purpose of this investigation was to evaluate the association of enteroaggregative Escherichia coli (EAEC) with acute diarrhea in children of South Asian populations. Our meta-analysis included 18 studies published between 1989 and 2011. The odds ratio (OR) was used to evaluate all available observational epidemiology studies. Modifying effects on the overall OR were approached with outlier, subgroup, cumulative, and cumulative recursive analyses. Synthesis of the 18 observational studies revealed an association between EAEC carriage and acute diarrhea, with an overall OR of 1.51, which was significant (p=0.008), heterogeneous (P heterogeneity <0.0001), and unaffected by outlier analysis. This analysis, however, affected the subgroups by eliminating the following: (i) heterogeneity (from P heterogeneity <0.0001 to 0.30-0.72) of pooled ORs in the underpowered (OR 1.37, p=0.15), Indian (OR 1.92, p=0.09), and hospitalbased (OR 1.66, p=0.06) studies; (ii) non-significance of these three subgroups (OR 1.56-2.01, p<0.0001-0.003); (iii) significance of the high-powered studies (from OR 1.70, p=0.02 to OR 1.15, p=0.28); (iv) heterogeneity (from P heterogeneity <0.0001-0.0002 to 0.11-0.15) of pooled ORs in period three (OR 1.85, p=0.14), population-based (OR 1.36, p=0.09), and pCVD432 (OR 1.53, p=0.07) studies. In general, outlier treatment increased precision with the narrowing of confidence intervals, overall, and in the subgroups. Cumulative meta-analysis generally resulted in increases in the frequencies of significant effects and of heterogeneity. This meta-analysis on observational studies suggests that the association between EAEC and acute diarrhea in children is that of increased risk. This effect generally comes from heterogeneous studies of South Asian populations, but is modified with outlier and subgroup treatments.
Antimicrobial resistance is a worldwide public health concern. Rise in the number of antimicrobia... more Antimicrobial resistance is a worldwide public health concern. Rise in the number of antimicrobial resistant organisms, such as extended spectrum β-lactamase- (ESBL) and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae, continue to burden millions of people worldwide. E. coli and K. pneumoniae were isolated and collected for four months from a teaching hospital in the Philippines. All isolates were subjected to ESBL and carbapenemase testing using the double disk synergy test and modified Hodge test, respectively. Their pattern of resistance among different classes of antimicrobial agents was also investigated using the Kirby-Bauer disk diffusion test. Among the 32 clinical isolates tested, 28.1% were positive for ESBL production and 6.3% were positive for carbapenemase production. Species-specific classification showed that E. coli (44.4%) has the highest rate of ESBL production whereas both E. coli (5.6%) and K. pneumoniae (7.1%) showed almost similar rates of ca...
Giardia duodenalis is considered the most common cause of parasitic diarrhea worldwide. Genetic s... more Giardia duodenalis is considered the most common cause of parasitic diarrhea worldwide. Genetic studies revealed that at least eight assemblages (A–H) exist. Of these assemblages, A and B are found primarily in human beings and occasionally in animals. The association between clinical symptoms and G. duodenalis assemblages is controversial. The aim of the present study was to determine the assemblages of G. duodenalis prevalent among Egyptian children with diarrhea. Therefore, 96 positive stool samples for Giardia by light microscopy were subjected to multilocus genotyping targeting the triose phosphate isomerase (tpi), βgiardin (bg), and glutamate dehydrogenase (gdh) genes. Amplified polymerase chain reaction (PCR) products were then purified, sequenced, and aligned with reference strains to determine the assemblages of the Giardia isolates. Out of the 96 microscopically positive stool samples for Giardia, 77 (80 %) were successfully amplified and sequenced at least at onelocus.Oft...
This chapter summarizes the progress in Escherichia coli research that used the meta-analysis app... more This chapter summarizes the progress in Escherichia coli research that used the meta-analysis approach. Using systematic searches for E. coli literature, we tracked meta-analysis publications and analyzed them based on a number of parameters. These included subject/topic (epidemiology, clinical/intervention/prevention and environmental), geographical region (the Americas, Europe and Australasia) and clinical syndrome (enteric, renal, and sepsis/meningitis). These parameters were plotted in terms of time span to obtain a sense of dynamic change or its absence through the years since the turn of the twentieth century. In terms of region, topic and syndrome, highest meta-analysis productivity was attributed to the Americas, clinical/intervention/prevention and enteric, all of which took place in the last 5 years (2011–2016). Over the combined time span of 16 years, the Americas significantly dominated meta-analysis outputs when compared to Europe and Australasia (P = 0.003). In conclus...
Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the numbe... more Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the number of new and undiagnosed cases continue to rise. Diagnosis of diabetes is usually performed by blood glucose analysis after fasting for a certain period. However, this method uses an invasive technique that can cause discomfort and even trauma to some patients which could eventually lead to behavioral changes such as avoidance of healthcare and laboratory testing. Studies that explore the diagnostic value of salivary glucose are promising due to the non-invasiveness of the test procedures and its potential correlation with blood results. Material and Methods The study conducted aimed to determine if salivary glucose can be utilized as an alternative to blood glucose in the screening, diagnosis, and monitoring of type 2 diabetes mellitus (T2DM). A total of 75 participants were recruited and equally divided into 3 groups (normal fasting glucose, impaired fasting glucose, and provisional DM...
Reported associations of CYP1A1 polymorphisms with breast cancer have been inconsistent. In this ... more Reported associations of CYP1A1 polymorphisms with breast cancer have been inconsistent. In this meta-analysis examining breast cancer associations of three CYP1A1 polymorphisms (M1, M2 and M4) among Indian women may yield information that may be of clinical and epidemiological use for this particular demography. We searched MEDLINE using PubMed and Embase for association studies. From seven published case-control studies, we estimated overall associations and applied subgroup analysis to explore differential effects. All three polymorphisms exhibited overall increased risk, significant in M1 (OR 1.61–1.65, p = 0.04) and M4 (OR 2.02–3.92, p = 0.02–0.04). Differential effects were observed only in the M1 polymorphism where M1 effects were significant in South Indians (OR 2.20–4.34, p < 0.0001) but not the North population, who were at reduced risk (OR 0.64– 0.77, p = 0.03–0.55). These populations were not materially different in regard to M2 and M4 as did the women stratified by m...
Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive funct... more Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published between 1992 and 2016. Medline, Biosis and Web of Science were searched for original studies published in the English language. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Pooled effect across studies were calculated as standardized mean differences (SMD) to compare cognitive and educational measures for STH infected/non-dewormed children versus STH uninfected /dewormed chi...
Background/Aims: Reported associations of reproductive outcomes (RO) and polycystic ovary syndrom... more Background/Aims: Reported associations of reproductive outcomes (RO) and polycystic ovary syndrome (PCOS) with genotypes of the Ile49Ser and -482A>G polymorphisms in the Anti-Müllerian hormone (AMH) gene and its type II receptor (AMHRII), respectively, have conflicting results. Methods: PubMed, Google Scholar and Science Direct databases were searched for studies that investigated Ile49Ser and -482A>G in RO and PCOS. Using the metaanalytic approach, we estimated risk (odds ratio [OR] with 95% confidence intervals) using standard genetic models. Results: All calculated summary effects were non-significant. Overall associations of Ile49Ser and -482A>G with RO were absent (OR 0.95-0.99, P = 0.76-0.96) but implied increased risk in PCOS (OR 1.07-1.17, P = 0.49-0.55). Where heterogeneity of the pooled ORs were present, its sources were explored using the Galbraith plot. Detection and omission of the outlying studies in both polymorphisms not only erased heterogeneity of the reca...
<p>Associations between <i>STH</i> infection/non-treatment and performance in c... more <p>Associations between <i>STH</i> infection/non-treatment and performance in cognitive and educational domains among school-aged children following exclusion of outlier investigations using the Galbraith plot method.</p
<p>Effect of <i>STH</i> infection/non-treatment on performance in cognitive and... more <p>Effect of <i>STH</i> infection/non-treatment on performance in cognitive and educational within strata of study designs, non-outlier investigations and study quality.</p
Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) con... more Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) concentration and to observe theeffect of single dose albendazole treatment on Hb concentration.Methods An experimental study was carried out from March toJuly 2002 on primary school children at Suka Village, Tiga PanahSubdistrict, Karo Regency, North Sumatera Province. From 366children who suffered from helminthiasis, 113 were selected assubjects by simple random sampling. Subjects were treated with asingle oral dose of 400 mg albendazole. Hb concentration wasexamined using the cyanide method twice i.e., prior to and threemonths after treatment with albendazole.Results It was found that among 113 subjects, the prevalences ofAscaris lumbricoides, Trichuris trichiura, and mixed infestation were18.3%, 40.4%, and 41.3%, respectively, while the prevalence ofanemia was 33.0%. There was no significant difference in age,gender, nutritional status, and mean Hb concentration betweenchildren sufferin...
<p>Log SMD: logarithm of standardized mean difference; SE: Standard error. Studies that lie... more <p>Log SMD: logarithm of standardized mean difference; SE: Standard error. Studies that lie below the– 2 or above the +2 confidence limit are the outliers.</p
<p>Diamond denotes the pooled standardized mean difference (SMD). Squares indicate the SMD ... more <p>Diamond denotes the pooled standardized mean difference (SMD). Squares indicate the SMD in each study, with square sizes directly proportional to the weight contribution (%) of each study. Horizontal lines represent 95% confidence intervals (CI). The Z test for overall effect indicates non-significance given that <i>P</i> > 0.05. The chi-square test indicates that heterogeneity (P = 0.12, I<sup>2</sup> = 33%) was reduced by outlier treatment. SD: standard deviation; CI: confidence interval; Std: standard; df: degree of freedom; I<sup>2</sup>: measure of variability expressed in %.</p
<p>Comparison of pooled effects between <i>STH</i> infection and respective out... more <p>Comparison of pooled effects between <i>STH</i> infection and respective outcomes with and without co-prevalent <i>Schistosoma</i> infection.</p
<p>Risk of bias in observational studies using the Newcastle-Ottawa quality assessment scal... more <p>Risk of bias in observational studies using the Newcastle-Ottawa quality assessment scale.</p
European Journal of Clinical Microbiology & Infectious Diseases, 2012
The purpose of this investigation was to evaluate the association of enteroaggregative Escherichi... more The purpose of this investigation was to evaluate the association of enteroaggregative Escherichia coli (EAEC) with acute diarrhea in children of South Asian populations. Our meta-analysis included 18 studies published between 1989 and 2011. The odds ratio (OR) was used to evaluate all available observational epidemiology studies. Modifying effects on the overall OR were approached with outlier, subgroup, cumulative, and cumulative recursive analyses. Synthesis of the 18 observational studies revealed an association between EAEC carriage and acute diarrhea, with an overall OR of 1.51, which was significant (p=0.008), heterogeneous (P heterogeneity <0.0001), and unaffected by outlier analysis. This analysis, however, affected the subgroups by eliminating the following: (i) heterogeneity (from P heterogeneity <0.0001 to 0.30-0.72) of pooled ORs in the underpowered (OR 1.37, p=0.15), Indian (OR 1.92, p=0.09), and hospitalbased (OR 1.66, p=0.06) studies; (ii) non-significance of these three subgroups (OR 1.56-2.01, p<0.0001-0.003); (iii) significance of the high-powered studies (from OR 1.70, p=0.02 to OR 1.15, p=0.28); (iv) heterogeneity (from P heterogeneity <0.0001-0.0002 to 0.11-0.15) of pooled ORs in period three (OR 1.85, p=0.14), population-based (OR 1.36, p=0.09), and pCVD432 (OR 1.53, p=0.07) studies. In general, outlier treatment increased precision with the narrowing of confidence intervals, overall, and in the subgroups. Cumulative meta-analysis generally resulted in increases in the frequencies of significant effects and of heterogeneity. This meta-analysis on observational studies suggests that the association between EAEC and acute diarrhea in children is that of increased risk. This effect generally comes from heterogeneous studies of South Asian populations, but is modified with outlier and subgroup treatments.
Antimicrobial resistance is a worldwide public health concern. Rise in the number of antimicrobia... more Antimicrobial resistance is a worldwide public health concern. Rise in the number of antimicrobial resistant organisms, such as extended spectrum β-lactamase- (ESBL) and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae, continue to burden millions of people worldwide. E. coli and K. pneumoniae were isolated and collected for four months from a teaching hospital in the Philippines. All isolates were subjected to ESBL and carbapenemase testing using the double disk synergy test and modified Hodge test, respectively. Their pattern of resistance among different classes of antimicrobial agents was also investigated using the Kirby-Bauer disk diffusion test. Among the 32 clinical isolates tested, 28.1% were positive for ESBL production and 6.3% were positive for carbapenemase production. Species-specific classification showed that E. coli (44.4%) has the highest rate of ESBL production whereas both E. coli (5.6%) and K. pneumoniae (7.1%) showed almost similar rates of ca...
Giardia duodenalis is considered the most common cause of parasitic diarrhea worldwide. Genetic s... more Giardia duodenalis is considered the most common cause of parasitic diarrhea worldwide. Genetic studies revealed that at least eight assemblages (A–H) exist. Of these assemblages, A and B are found primarily in human beings and occasionally in animals. The association between clinical symptoms and G. duodenalis assemblages is controversial. The aim of the present study was to determine the assemblages of G. duodenalis prevalent among Egyptian children with diarrhea. Therefore, 96 positive stool samples for Giardia by light microscopy were subjected to multilocus genotyping targeting the triose phosphate isomerase (tpi), βgiardin (bg), and glutamate dehydrogenase (gdh) genes. Amplified polymerase chain reaction (PCR) products were then purified, sequenced, and aligned with reference strains to determine the assemblages of the Giardia isolates. Out of the 96 microscopically positive stool samples for Giardia, 77 (80 %) were successfully amplified and sequenced at least at onelocus.Oft...
This chapter summarizes the progress in Escherichia coli research that used the meta-analysis app... more This chapter summarizes the progress in Escherichia coli research that used the meta-analysis approach. Using systematic searches for E. coli literature, we tracked meta-analysis publications and analyzed them based on a number of parameters. These included subject/topic (epidemiology, clinical/intervention/prevention and environmental), geographical region (the Americas, Europe and Australasia) and clinical syndrome (enteric, renal, and sepsis/meningitis). These parameters were plotted in terms of time span to obtain a sense of dynamic change or its absence through the years since the turn of the twentieth century. In terms of region, topic and syndrome, highest meta-analysis productivity was attributed to the Americas, clinical/intervention/prevention and enteric, all of which took place in the last 5 years (2011–2016). Over the combined time span of 16 years, the Americas significantly dominated meta-analysis outputs when compared to Europe and Australasia (P = 0.003). In conclus...
Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the numbe... more Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the number of new and undiagnosed cases continue to rise. Diagnosis of diabetes is usually performed by blood glucose analysis after fasting for a certain period. However, this method uses an invasive technique that can cause discomfort and even trauma to some patients which could eventually lead to behavioral changes such as avoidance of healthcare and laboratory testing. Studies that explore the diagnostic value of salivary glucose are promising due to the non-invasiveness of the test procedures and its potential correlation with blood results. Material and Methods The study conducted aimed to determine if salivary glucose can be utilized as an alternative to blood glucose in the screening, diagnosis, and monitoring of type 2 diabetes mellitus (T2DM). A total of 75 participants were recruited and equally divided into 3 groups (normal fasting glucose, impaired fasting glucose, and provisional DM...
Reported associations of CYP1A1 polymorphisms with breast cancer have been inconsistent. In this ... more Reported associations of CYP1A1 polymorphisms with breast cancer have been inconsistent. In this meta-analysis examining breast cancer associations of three CYP1A1 polymorphisms (M1, M2 and M4) among Indian women may yield information that may be of clinical and epidemiological use for this particular demography. We searched MEDLINE using PubMed and Embase for association studies. From seven published case-control studies, we estimated overall associations and applied subgroup analysis to explore differential effects. All three polymorphisms exhibited overall increased risk, significant in M1 (OR 1.61–1.65, p = 0.04) and M4 (OR 2.02–3.92, p = 0.02–0.04). Differential effects were observed only in the M1 polymorphism where M1 effects were significant in South Indians (OR 2.20–4.34, p < 0.0001) but not the North population, who were at reduced risk (OR 0.64– 0.77, p = 0.03–0.55). These populations were not materially different in regard to M2 and M4 as did the women stratified by m...
Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive funct... more Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published between 1992 and 2016. Medline, Biosis and Web of Science were searched for original studies published in the English language. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Pooled effect across studies were calculated as standardized mean differences (SMD) to compare cognitive and educational measures for STH infected/non-dewormed children versus STH uninfected /dewormed chi...
Background/Aims: Reported associations of reproductive outcomes (RO) and polycystic ovary syndrom... more Background/Aims: Reported associations of reproductive outcomes (RO) and polycystic ovary syndrome (PCOS) with genotypes of the Ile49Ser and -482A>G polymorphisms in the Anti-Müllerian hormone (AMH) gene and its type II receptor (AMHRII), respectively, have conflicting results. Methods: PubMed, Google Scholar and Science Direct databases were searched for studies that investigated Ile49Ser and -482A>G in RO and PCOS. Using the metaanalytic approach, we estimated risk (odds ratio [OR] with 95% confidence intervals) using standard genetic models. Results: All calculated summary effects were non-significant. Overall associations of Ile49Ser and -482A>G with RO were absent (OR 0.95-0.99, P = 0.76-0.96) but implied increased risk in PCOS (OR 1.07-1.17, P = 0.49-0.55). Where heterogeneity of the pooled ORs were present, its sources were explored using the Galbraith plot. Detection and omission of the outlying studies in both polymorphisms not only erased heterogeneity of the reca...
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